Emotional Blunting and Anhedonia

No doubt in my mind that, for many, this is part of the syndrome itself and not a secondary effect born out of other symptoms. The decrease of neurosteroids found in PFS patients (far lower than in found in other depressive conditions) indicates a biological alteration in the mind/brain.

The Boston study found similarities in brain (dys-)function between PFS patients and people with psychogenic (hate the connotation that word carries) erectile dysfunction when exposed to erotic stimuli. This also goes to show there is something happening in the mind, independently from physical aspects.

There are many studies of animals exposed to Accutane (not quite the same as PAS) where changes in neurogenesis and connectivity were observed in parts of the brain responsible for sexual excitation (hypothalamus), memory (hippocampus), and serotogenic signalling (raphe nuclei). These regions are associated with emotion, but I donā€™t think their roles have been clearly defined.

It is not uncommon for PAS patients to have only the emotional blunting and personality changes. Seen a few post-Accutane stories where this is described.

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I think anhedonia and depression are entirely the result of lack of libido and sexual dysfunction. I will come back to this thread in a couple of days to argue the point.

Nope thats wrong. My sexual symptoms are almost all cured now but my anhedonia is not.

I also had times with zero libido but no anhedonia. Theres no connection. Its just the AR not working properly in specific brain areas. Maybe even dopamine receptor overexpression too, who knows.

Iā€™ve experienced every combination you could think of to some degree. Severe ED when libido and emotions were relatively okay, strong erections when libido and emotion were totally absent, have had moments of decent libido with no physical response and left wondering why. Itā€™s usually bad on all accounts, unfortunately. I would argue that libido and emotions are linked though. Perhaps libido could even be considered an emotion in its own right?

What a frustrating mess for all of us.

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Very wrongā€¦I donā€™t give a rats ass abut sex and my dick is great but my health is gone and body is falling apartā€¦Sorry was replying to sebelio

It is Sibelio, from ā€œSibeliusā€. :slight_smile:

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I have the emotional blunting. At least 75% of my emotions are blunted, last month i felt like it was better though for a few weeks because I was more optimistic and i (think?) i was taking some vitamin supplements i may be deficient in.

@joetz also suffered from the no emotions, but apparently he has solved it through stem cell procedure

I havenā€™t had an emotion in 7 months since I crashed completely. Itā€™s not related to depression over sexual issues. Emotional blunting was always a side effect SSRIs. Never to this extent though. It comes from complete lack of dopamine.

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So you canā€™t cry at all? What about laugher? Is that an emotion?

No, both sadness and humor are gone. I can occasionally produce tears but it only comes from behind the eyes. No gut feelings anymore. Itā€™s no way to live.

Hippydoof, even though you may not feel emotions it doesnā€™t make you useless. You can give so much to others, society and the world at large. You can make a difference. Itā€™s important to realise that your existence isnā€™t just about you. Everybody and everything are connected.

It took me quite a while to come to this conclusion, but it seems to be the truth of the matter. Itā€™s the way I face each day. I ask myself, ā€˜What can I do to make things better? To make some order out of the chaos which confronts us?ā€™ Each day, try to do something to make somebodyā€™s life better. Work towards a goal to help others and make the world a less harsh place.

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I also have somewhat anhedonia and emotional blunting. Whatā€™s interesting is that I can use magnesium (lactate seems best) to modulate this somehow. If Iā€™m without magnesium and I start taking it, it brings temporary recovery to some degree; more emotions, libido and penis sensitivity. Then the body adapts and I go back to my PFS state, which today consists primarily of emotional and libido issues together with the hellish penis sensitivity issue.

If I then quit magnesium when Iā€™m on it, another temporary recovery-like state appears. This goes on for some days but then I go back to the state Iā€™m usually in.

I use Prescript Assist (PA) and it actually helps quite a bit with the penis sensitivity issue (!). So there is something happening with signals/receptors that is related to the gut and that helps me here.

Today I take PA and magnesium. I occasionally take some Citrulline Malate since it helps with blood flow and exercise gains.

However, if I take too much Citrulline, Glutamine or even touch BCAA I can get rather hellish anhedonia. I took 1-2 scoops of BCAA the other day and I was sitting in my sofa wondering what the point with being alive was. Pretty scary, mildly put. Citrulline also has a 6 week washout (atleast the corresponding NO) so I can actually feel it for those weeks. I feel somewhat vulnerable when I go down to baseline without it.

I will try tyrosine and levodopa but it doesnā€™t seem these are any silver bullets from what Iā€™ve read on here, so Iā€™m rather pessimistic.

If you decide to try magnesium (or if youā€™re on it) please be aware that magnesium oxide seems to lower stomach acid over time. I read this on the web, but I donā€™t remember where. This can completely wreak havoc for us PFS sufferers who probably have a vulnerable gut in the first place. It did to me; I developed malabsorption, anxiety, pelvic pain symptoms and sleep problems from it and Iā€™m still taking loads of HCL pills trying to repair my digestion. I can take 10 and more of them without getting any acid reflux. When I started HCL my sleep problems subsided, as did the anxiety and many of the ā€œstress response -> pelvic painā€ problems I experienced. However, I must say that I would love to feel a bit anxious since Iā€™m starting to forget how it feels.

I would advice anyone having PFS to try HCL to see if stomach acid is low.

Can you cycle magnesium for these effects? Have you tried altered doses? Iā€™m wondering if thereā€™s a sweet spot.

Yes, it seems I can. As for the dosage, I havenā€™t found any sweet spot since the body seems to tilt itself into ā€œPFS spaceā€ no matter what I do.

The sad part: I feel more robust now, since my stomach is much better, which is good. But at the same time I feel more disconnected and I have less libido than one year ago, when I first started on this magnesium/PA combo. At that time I took 400 mg of Swansons shitty magnesium oxide/stearate blend, which caused the problems I mentioned, in the long run.

So, there has been some magnesium increase/decrease cycles and Iā€™m not permanently better. So I canā€™t see how Iā€™m going to get better by cycling moreā€¦directly/controlled. In my daily/weekly notes, I can see that the times Iā€™ve had good libido has been in a magnesium increase/decrease phase. Which is puzzling and annoying at the same time.

I canā€™t be with girls because Iā€™m not able to be attracted enough these days, at least not in a stable manner. I have tried with several and the emotional sides are one thing but the sexual performance is just too weak. I must admit; I havenā€™t been able to have a proper intercourse (sorry the formal language) after fin without Prescript Assist. One year ago I had something that started to look like sex again. That was with only magnesium and PA. If I quit PA, the penis sensitivity drops and Iā€™m sexually uninterested, unless Iā€™m in a magnesium increase/decrease phase.

i havent cried since my crash 10 months ago ā€¦ before every 2 weeks hahaā€¦ i mean i can cry. but no tears come out. its so strange. all this shit makes me religious ā€¦ i think god fucked us up for some reason. i know its not rational but it feels so unreal.

This has been the worst aspect of PFS. Before this I was really sociable and loved spending time outside. Maintaining physical relationships became a chore and conversations felt unnatural. This is what drove me to try glutathione. I started feeling sociable and natural again but crashed badly due to poor dosing. Read @Ozephs blog on using amino acids to improve focus & motivation, itā€™s really interesting and may help with some aspects of emotional blunting.

Pssdforumā€™s user Mesolimbo treated emotional blunting with baclofen successfully, but effects wore off after discontinuation.

Coincidentally it worked very well for me for this as well (for a long time, close to a year), but currently doesnā€™t have as much of an effect as before, if much at all. Considering taking a break to test it again.

If anyone has any anecdotal reports or literature on the best dosing schedule to maintain for the positive effects of baclofen to stay, Iā€™d be open to it. It worked best for me when I was taking it 2x a week, although I did take it 3x a week for a few months with good results. Every other day dosing seemed to be too much and caused tolerance issues for me, as well as some mild withdrawal upon discontinuation every time I did.

If I remember correctly, Mesolimbo is using Memantine to not develop tolerance on baclofen